Background. Obesity is characterized by liver steatosis, chronic inflammation, and increased liver enzymes, that is, gamma-glutamyltransferase (GGT) and alanine aminotransferase (ALT), markers for nonalcoholic fatty liver disease (NAFLD) and liver fat content. Increased platelet counts (PCs) are associated with inflammatory conditions and are a valuable biomarker of the degree of fibrosis in NAFLD. We investigated alterations in PC, GGT, and ALT after biliopancreatic diversion with duodenal switch (BPD-DS) and Roux-en-Y gastric bypass (RYGBP). Methods. Ten morbidly obese patients (body mass index, BMI: ？kg/m2) who underwent BPD-DS were evaluated preoperatively (baseline) and 1 year (1st followup) and 3 years (2nd followup) after surgery and compared with 21 morbidly obese patients (BMI: ？kg/m2) who underwent RYGBP. Results. Over the 3 years of followup, changes in BPD-DS and RYGBP patients (BPD-DS/RYGBP) were as follows: BMI (？44%/？24%), GGT (？63%/？52%), and ALT (？48%/？62%). PC decreased (？21%) statistically significantly only in BPD-DS patients. Conclusions. Morbidly obese patients treated by RYGBP or BPD-DS show sustained reductions in BMI, ALT, and GGT. The decrease in PC and liver enzymes after BPD-DS may reflect a more pronounced decrease of liver-fat-content-related inflammation and, as a result, a lowered secondary thrombocytosis. 1. Introduction Bariatric surgery has become an effective treatment for obesity, also reducing the onset of type 2 diabetes mellitus (T2DM) [1] as well as inducing remission [2] and reducing cardiovascular mortality and mortality in general [3, 4]. Obesity is a chronic condition characterized by elevated inflammatory markers [5–7] and is associated with nonalcoholic fatty liver disease (NAFLD) [8, 9]. Serum gamma-glutamyltransferase (GGT) and alanine aminotransferase (ALT) are markers of NAFLD and of liver fat content [10, 11]. Increased platelet counts have been observed in conditions with chronic inflammation as well as in obesity, probably due to secondary thrombocytosis [12–14]. In more advanced stages of NAFLD, with portal hypertension and splenomegaly, reduced platelet counts have been observed [15]. There is a linear association between decreased platelet counts and increased fibrosis in the histopathology of liver biopsies, which may indicate that platelet counts might be an important biomarker of the degree of fibrosis in NAFLD patients. Platelet count is a simple, easy to perform, cost-effective, and accurate surrogate marker for predicting fibrosis severity in NAFLD patients [16]. Bariatric surgery improves
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